Foreword

Since finishing my fellowship in neurology at University Hospitals Case Western Reserve University, I have been involved in both the clinical evaluation and treatment of patients with multiple sclerosis for more than 35 years, as well as clinical and translational research on multiple sclerosis. I have seen various therapies used, beginning with steroids and ACTH. In some situations, agents were later developed and were found to be effective in reducing acute inflammatory activity or were agents directed toward symptom management. These agents for disease control often times fell short of anticipated needs. They also were associated with high-cost and significant side effect profiles, and, as a result, patients often times, were non-compliant in taking the medicines. Because multiple sclerosis is a chronic progressive disease and rarely acutely life-threatening, yet it shortens life span, the treatment has often primarily focused on the patient’s symptom management and reduction of acute flares. Funding has been limited in clinical trials because of the potential high cost of implementing prospective studies. Nonetheless the basic science of multiple sclerosis, as well as clinical research, has continued with incremental advances in understanding multiple sclerosis and in seeking improved ways of analysis and treatment. CONTINUE READING…..